effect of varicocelectomy on seminal parameters and serum hormones [follicle stimulating hormone [FSH], testosterone] in infertile men with varicocele

To assess the effects of varicocelectomy on testicular functions; semen quality and serum hormones [FSH, testosterone] in patients suffering from infertility and having clinical varicoceles. Fifty-three infertile patients, their ages ranged from 25-45 years and having clinical varicoceles [14 bilateral, 39 left side only], underwent inguinal varicocelectomy. Semen analysis [at least 3 times] was performed before varicocelectomy and 6 and 12 months after the operation. Also serum hormones [FSH, testosterone] were measured before and 6 months after surgery. Before varicocelectomy the patients were classified into 4 groups according to their total motile sperm counts [TMS]. After varicocelectomy the mean relative increases in TMS were calculated for each group. Also the mean increase or decrease in serum testosterone and FSH were calculated. The patients were followed for a mean follow up of 25 months [range 6-55] and all pregnancies that occurred during the follow up were reported.Patients with mild .and moderate oligoasthenospermia showed significantly better seminal improvement following varicocelectomy, than patients with severe oligoasthenospermia and patients with azoospermia, in whom the improvement in semen quality was little after the operation. Serum FSH decreased in about 35% of the patients, from a mean of 13.8 +/- 2.4 before varicocelectomy to a mean of 9.6 +/- 1.8 mIU/mL by 6 months after the operation. Also serum testosterone increased, in about 50% of the patients, from a mean of 5.2 +/- 1.5 before varicocelectomy to a mean of 8.5 +/- 1.6 ng/mL by 6 months after the operation.There were 13 pregnancies by natural conception during the follow up period.Most of these pregnancies occurred 6 months to 2 years after surgery and most were in postoperative group A [10 pregnancies] when the TMS improved> 30 million. Varicocelectomy is the most effective initial intervention in males with mild or moderate oligoasthenospermia with clinical varicoceles. Varicocelectomy improves testicular functions, with significant increase in serum testosterone and significant improvement in sperm concentration and motility

Use of autologous fibrin glue in splenic salvage after its traumatic injuries

To avoid the well known risks of splenectomy and preserve the splenic function after its traumatic injuries, splenic salvage by using autologous fibrin glue [AFG] is particulary promising because of its unique characteristics. In this study we evaluated the efficacy and compatibility of AFG by its application to fourteen partially splenectomized New Zealand White rabbits. There was complete haemostasis in all animals, and the histopathological examination after re-exploration of the experimental animals within 24 hours, and 2 weeks revealed no body reaction and good healing. As the reparation time of AFG was suitable [30-44mins] and due to its good results on animals, we applied this material on six patients with different splenic injuries [fissures and evulsion of one pole]. Through the follow up period of two weeks by using haematocrite value, U.S., C.T, there was no recurrent bleeding from splenic sites. For that we concluded that AFG is an effective haemostatic agent with good systemic and local compatibility and can be used in splenic salvage, which therapy avoids the use of non-autologous products with their risks of diseases transmission and anaphylactic reaction

place of laparoscopy in acute abdomen

Laparoscopy offers a simple safe and rapid mean of evaluation and diagnosis of intrabdominal diseases when the indications for laparotomy are equivocal. In this study laparoscopy was employed in 60 patients with acute abdomen. Three categories of patients were included, those with queery acute appendicitis [40 patients], those with blunt abdominal trauma [10 patients] and those with a provisional diagnosis of acute cholecystitis [10 patients]. Laparoscopy was done for every case for diagnosis and proceed accordingly.It was concluded that, laparoscopy is a very useful procedure in managing the patient who complained of acute abdominal pain and indication for laparotomy is equivocal. So the main value of laparoscopy in such cases were either avoiding unnecessary laparotomy or proceeding laparoscopically or ending into laparotomy